Retroperitoneal fibrosis (RPF) is a rare disease characterized by marked fibro-inflammatory tissue in the retroperitoneum. Approximately 70% of cases of RPF are idiopathic, while the rest can be secondary to several other causes. The diagnosis is mainly obtained by imaging modalities such as computed tomography (CT). However, histological examination should be considered when the clinical manifestations and imaging studies suggest malignancy. In particular, in malignant diseases with retroperitoneal metastases, abnormal collagen plaques are formed from an exuberant desmoplastic response, which may not be distinguishable from RPF on CT scans. Therefore, even if CT suggests RPF, biopsy is essential to identify malignant disease because it typically results in a fatal prognosis. Here, we report a case of metastatic adenocarcinoma of unknown primary site that developed only in the retroperitoneum and was initially diagnosed as RPF based on CT findings.
Adenocarcinoma ; Biopsy ; Collagen ; Diagnosis ; Neoplasm Metastasis ; Neoplasms, Unknown Primary ; Prognosis ; Rare Diseases ; Retroperitoneal Fibrosis* ; Tomography, X-Ray Computed

No abstract available.
Eosinophilic Granuloma* ; Eosinophils*

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkin's lymphoma (NHL) and that progresses rapidly and is usually fatal. Because it usually presents with nonspecific symptoms, such as fever, the early diagnosis of IVLBCL is very difficult and it is often misdiagnosed as another disease. Systemic lupus erythematosus (SLE) is an autoimmune disease that affects various organs. The clinical manifestation of SLE ranges from rash and arthritis through anemia and thrombocytopenia to serositis, nephritis, seizures, and psychosis. Thus, it can be easily confused with many other disorders. We report a case of IVLBCL mimicking SLE in the initial diagnosis.
Anemia ; Arthritis ; Autoimmune Diseases ; B-Lymphocytes* ; Diagnosis ; Early Diagnosis ; Exanthema ; Fever ; Lupus Erythematosus, Systemic* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Nephritis ; Psychotic Disorders ; Seizures ; Serositis ; Thrombocytopenia

A 53-year-old male was admitted to our hospital for evaluation of the second kidney transplant. A Iliopsoas Bursitis was detected on diagnostic abdominopelvic computed tomography. He had undergone a coronary angiography (CAG) due to chest pain 1 month prior to his visit. At that time, he had experienced pain on his right back and flank for some time. We found no other causes or predisposing factors associated with that problem. Thus, we report on a case of iliopsoas bursitis after CAG.
Bursitis* ; Causality ; Chest Pain ; Coronary Angiography* ; Humans ; Kidney ; Kidney Transplantation ; Male ; Middle Aged

A 79-year-old woman was admitted to our hospital for shoulder pain. A physical examination revealed a tender right shoulder with limitation of active, and preservation of passive, motion. She had undergone a cerebral angiography with coil embolization two months prior to admission. After the procedure, she was presented with pain in the right upper arm and shoulder. Due to persistent shoulder pain, an MRI of the shoulder was performed, and osteonecrosis of the humeral head was detected. We present a case of osteonecrosis of the humeral head after cerebral angiography.
Aged ; Arm ; Cerebral Angiography* ; Embolization, Therapeutic ; Female ; Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Osteonecrosis* ; Physical Examination ; Shoulder ; Shoulder Pain

PURPOSE: This study was performed to determine the relationship between PTEN and vascular endothelial growth factor (VEGF) expression and to assess their roles in the tumor-induced angiogenesis and tumor progression in non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissues, from 96 patients diagnosed with NSCLC, were evaluated for VEGF and PTEN expression using immunohistochemical methods. The results of the expression pattern of VEGF alone, or in combination with PTEN expression, were compared with clinicopathological parameters. RESULTS: VEGF expression was seen in 54 (56.3%) of the 96 NSCLCs evaluated, and was significantly correlated with histological type, and seen more frequently in adenocarcinomas compared to the other histological types (p<0.05). There were no significant associations between VEGF expression and tumor size, lymph node metastasis and stage. The microvessel density (MVD) determined by CD34 staining were significantly higher in tumors with VEGF expression (62.9+/-21.8) than those without (55.1+/-15.1). Loss of PTEN expression was seen in 33 (34.4%) of the 96 NSCLCs evaluated. VEGF expression was more frequently detected in the tumors with loss of PTEN expression (69.7%) than in those with PTEN expression (49.2%). When the combined VEGF/ PTEN phenotypes were divide into two groups; group I (VEGF-/PTEN+) and group II (VEGF-/ PTEN-, VEGF+/PTEN+, VEGF+/PTEN-), a significant correlation was also seen between the groups and the histologic types. There was a trend for the tumors in group II to show more frequent lymph node metastasis (50.0%) than those in group I (31.5%), although there was no statistical significance. The MVDs were significantly higher in group II (63.1+/-20.7) than in group I (53.4+/-17.2). CONCLUSION: These findings demonstrate an inverse correlation between the expressions of PTEN and VEGF. It is possible that PTEN may repress VEGF expression, and modulate VEGF-mediated angiogenesis, which suggests further analysis of the complex phenomenon of neo-angiogenesis in NSCLC is essential.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Chromosomes, Human, Pair 10 ; Humans ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Phenotype ; Vascular Endothelial Growth Factor A*

Dermatomyositis (DM) is an autoimmune disease characterized by subacute-onset proximal symmetric muscle weakness, skin abnormalities, and muscle inflammation. Descriptions of DM as a complication of chronic graft-versus-host disease (cGVHD) are very rare. We report a 50-year-old woman who developed DM associated with cGVHD after allogeneic stem cell transplantation.
Autoimmune Diseases ; Dermatomyositis* ; Female ; Graft vs Host Disease* ; Humans ; Inflammation ; Middle Aged ; Muscle Weakness ; Skin Abnormalities ; Stem Cell Transplantation ; Stem Cells* ; Transplantation*

Polymyalgia rheumatica (PMR) is an uncommon disorder characterized by bilateral pain and stiffness in the shoulder and pelvic girdles. Polymyalgia rheumatica and giant cell arteritis (GCA) occur in the same patient population and share a common pathogenesis. Giant cell arteritis predominantly affects the cranial arteries and rarely involves the gastrointestinal tract. Moreover, giant cell arteritis has rarely been reported in Asians. Here, we present a case with 62-year-old Asian woman who developed polymyalgia rheumatica with localized vasculitis in the mesenteric arteries.
Arteries ; Asian Continental Ancestry Group ; Female ; Gastrointestinal Tract ; Giant Cell Arteritis ; Humans ; Mesenteric Arteries ; Middle Aged ; Polymyalgia Rheumatica* ; Shoulder ; Vasculitis*

Hypertrophic osteoarthropathy is a syndrome characterized by periosteal new bone formation, arthritis, and clubbing of the fingers and toes. The majority of cases occur secondarily to the conditions associated with pulmonary, cardiac, gastrointestinal disorders or other systemic diseases. There are many cases with malignancy worldwide. We report the first patient who had hypertrophic osteoarthropathy due to metastatic cancer after surgical removal for mucoepidermoid carcinoma of the parotid gland.
Arthritis ; Carcinoma, Mucoepidermoid* ; Fingers ; Humans ; Lung* ; Neoplasm Metastasis* ; Osteogenesis ; Parotid Gland* ; Toes

Mycobacterium avium complex (MAC) comprises M. intracellulare and M. avium. MAC usually causes pulmonary diseases in individuals with intact immunity, disseminated disease in patients with acquired immunodeficiency syndrome, and cervical lymphadenitis. It can also cause cutaneous disease, but musculoskeletal infection is rare. Herein, we present a case of vertebral osteomyelitis due to M. intracellulare in an elderly immunocompetent patient who underwent vertebroplasty. The patient was successfully treated with antimycobacterial drugs without surgical intervention. MAC should be considered as a causative pathogen of vertebral osteomyelitis when the patient has a history of vertebroplasty.
Acquired Immunodeficiency Syndrome ; Aged* ; Humans ; Lung Diseases ; Lymphadenitis ; Mycobacterium avium Complex* ; Mycobacterium avium-intracellulare Infection ; Mycobacterium* ; Nontuberculous Mycobacteria ; Osteomyelitis* ; Vertebroplasty*